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Int. J. Environ. Res. Public Health, Volume 20, Issue 14 (July-2 2023) – 115 articles

Cover Story (view full-size image): Living near green and blue spaces is good for health and wellbeing. However, coastal communities in England are often associated with poor health, particularly among those aged over 50. To explore how the salutogenic potential of nature might be more effectively harnessed in such locations, this study investigated the experiences of older adults in a coastal town. From the analysis of semi-structured interviews, we found that participants appreciate hyper-local natural spaces with amenities, particularly when they feel connected to those spaces. The accessibility (physical and psychological) and sensory qualities of the spaces are important. The findings suggest that health-promoting policies should incorporate the wellbeing potential of local green and blue spaces and include ways of increasing accessibility and nature connectedness. View this paper
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16 pages, 885 KiB  
Review
Culturally Informed Australian Aboriginal and Torres Strait Islander Evaluations: A Scoping Review
by Kristina Vine, Tessa Benveniste, Shanthi Ramanathan, Jo Longman, Megan Williams, Alison Laycock and Veronica Matthews
Int. J. Environ. Res. Public Health 2023, 20(14), 6437; https://doi.org/10.3390/ijerph20146437 - 24 Jul 2023
Viewed by 2558
Abstract
Rigorous and effective evaluations inform policy and service delivery and create evidence of program impacts and outcomes for the communities they are designed to support. Genuine engagement of communities is a key feature of effective evaluation, building trust and enhancing relevancy for communities [...] Read more.
Rigorous and effective evaluations inform policy and service delivery and create evidence of program impacts and outcomes for the communities they are designed to support. Genuine engagement of communities is a key feature of effective evaluation, building trust and enhancing relevancy for communities and providing meaningful outcomes and culturally relevant findings. This applies to Indigenous peoples’ leadership and perspectives when undertaking evaluations on programs that involve Indigenous communities. This systematic scoping review sought to explore the characteristics of culturally informed evaluations and the extent of their application in Australia, including the use of specific evaluation tools and types of community engagement. Academic and grey literature were searched between 2003 and 2023, with 57 studies meeting the inclusion criteria. Over time, there was an increase in the number of culturally informed evaluations undertaken, predominantly in the health and wellbeing sector. Around a quarter used a tool specifically developed for Indigenous evaluations. Half of the publications included Indigenous authorship; however, most studies lacked detail on how evaluations engaged with communities. This review highlights the need for further development of evaluation tools and standardised reporting to allow for shared learnings and improvement in culturally safe evaluation practices for Aboriginal and Torres Strait Islander communities. Full article
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14 pages, 1165 KiB  
Article
Comparative Analysis of Health- and Vision-Related Quality of Life Measures among Trinidadians with Low Vision and Normal Vision—A Cross-Sectional Matched Sample Study
by Kingsley K. Ekemiri, Edith N. Botchway, Ngozika E. Ezinne, Nikolai Sirju, Tea Persad, Hlabje Carel Masemola, Sherphard Chidarikire, Chioma C. Ekemiri and Uchechukwu Levi Osuagwu
Int. J. Environ. Res. Public Health 2023, 20(14), 6436; https://doi.org/10.3390/ijerph20146436 - 24 Jul 2023
Viewed by 2466
Abstract
This cross-sectional study investigated the health-related and vision-related quality of life measures of adults with low vision compared to healthy individuals in Trinidad and Tobago. The health-related quality of life (HRQOL-14) and the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) were administered to [...] Read more.
This cross-sectional study investigated the health-related and vision-related quality of life measures of adults with low vision compared to healthy individuals in Trinidad and Tobago. The health-related quality of life (HRQOL-14) and the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) were administered to 20 participants with low vision caused by diabetic retinopathy, retinitis pigmentosa, glaucoma, and macular degeneration, as well as 20 participants with no visual problems (control). Participants were recruited from the University Eye Clinic in Trinidad and Tobago. Compared to the controls, more participants in the low-vision group had lower age-adjusted NEI-VFQ-25 scores (48.3% vs. 95.1%; p < 0.001), had poor general (47.5% vs. 10%, p = 0.004) and mental (100% vs. 10%, p < 0.042) health, experienced greater activity limitation due to impairment or health problems (85% vs. 20%, p < 0.001), needed help with personal care (27.5% vs. 0%, p < 0.009) and daily routine (67.5% vs. 0%, p < 0.001), and experienced sleep problems (97.5% vs. 65%, p < 0.001) and symptoms of anxiety (100% vs. 90%, p = 0.042). All the diabetic retinopathy participants (100%, p = 0.028) had two or more impairments or vision problems compared to none in the other low-vision participants. In summary, the HRQOL-14 and NEI-VFQ-25 scores were significantly reduced in low-vision participants, who also demonstrated a greater vulnerability to poor quality of life in the presence of diabetes retinopathy. These findings have important clinical implications regarding offering appropriate support and interventions to improve quality of life outcomes in individuals with low vision. Full article
(This article belongs to the Section Health-Related Quality of Life and Well-Being)
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14 pages, 618 KiB  
Article
Examining the Effect of a Parent-to-Parent Intervention for Low-Income Youth with Serious Emotional and Behavioral Challenges
by Lindsay B. Poole, John S. Carlson, Kim Batsche-McKenzie, Justin Tate and Jane Shank
Int. J. Environ. Res. Public Health 2023, 20(14), 6435; https://doi.org/10.3390/ijerph20146435 - 24 Jul 2023
Viewed by 1126
Abstract
Background: Numerous barriers to mental health utilization exist for families of children who present with serious emotional and behavioral challenges. Evidence-based practices that facilitate equitable outcomes across diverse populations are essential to identify. This study examined possible differential service outcomes in a Medicaid-funded, [...] Read more.
Background: Numerous barriers to mental health utilization exist for families of children who present with serious emotional and behavioral challenges. Evidence-based practices that facilitate equitable outcomes across diverse populations are essential to identify. This study examined possible differential service outcomes in a Medicaid-funded, parent-to-parent intervention called Parent Support Partner (PSP). Method: Data from four hundred and sixty-four parents who received PSP services were evaluated for possible demographic differences in service completion. Within-group analyses were utilized for an analysis of outcomes (parent change, child functioning; treatment acceptability) within a subset (N = 153) of those who completed services. Results: No racial disparities were found in those who completed PSP (43%) when compared to those who did not (57%). Regression analyses uncovered significant improvements in parent competence and confidence, as well as overall child functioning (global functioning across domains such as school, home, behaviors). Consistent with identifying evidence-based practices, findings were seen consistently across the diverse sample of those who completed PSP services. Improvements in parents’ sense of competence and confidence were correlated with perceptions of treatment acceptability. Discussion: PSP is an innovative and promising intervention with demonstrated high levels of acceptability found to increase parent confidence and self-competence to advocate for treatments that can improve the mental health functioning of their child. Future investigations of factors associated with increasing PSP service completion and outcomes in larger and more diverse populations are necessary. Implications for considering and possibly adopting this evidence-informed practice within the nursing profession are provided. Full article
(This article belongs to the Special Issue Evidence-Based Practice in Nursing)
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18 pages, 3559 KiB  
Article
Microplastic Pollution Prevention: The Need for Robust Policy Interventions to Close the Loopholes in Current Waste Management Practices
by Hiroshan Hettiarachchi and Jay N. Meegoda
Int. J. Environ. Res. Public Health 2023, 20(14), 6434; https://doi.org/10.3390/ijerph20146434 - 23 Jul 2023
Cited by 8 | Viewed by 2492
Abstract
Plastic materials that are less than 5 mm in size are defined as Microplastics (MPs). MPs that are intentionally produced are called primary MPs; however, the most abundant type in the environment consists of the remainder created by the fragmentation of large plastic [...] Read more.
Plastic materials that are less than 5 mm in size are defined as Microplastics (MPs). MPs that are intentionally produced are called primary MPs; however, the most abundant type in the environment consists of the remainder created by the fragmentation of large plastic debris through physical, chemical, and oxidative processes, which are called secondary MPs. Due to their abundance in the environment, poor degradability, toxicological properties, and negative impact on aquatic and terrestrial organisms, including humans, MP pollution has become a global environmental issue. Combatting MP pollution requires both remediation and preventive measures. Although remediation is a must, considering where the technology stands today, it may take long time to make it happen. Prevention, on the other hand, can be and should be done now. However, the effectiveness of preventive measures depends heavily on how well MP escape routes are researched and understood. In this research, we argue that such escape routes (rather, loopholes) exist not only due to mismanaged plastic waste, but also due to cracks in the current waste management systems. One known MP loophole is facilitated by wastewater treatment plants (WWTP). The inability of existing WWTP to retain finer MPs, which are finally released to water bodies together with the treated wastewater, along with the return of captured larger MPs back to landfills and their release into the environment through land applications, are a few examples. Organic waste composting and upcycling of waste incineration ash provide other MP escape pathways. In addition, it is important to understand that the plastics that are in current circulation (active use as well as idling) are responsible for producing MPs through regular wear and tear. Closing these loopholes may be best attempted through policy interventions. Full article
(This article belongs to the Section Environmental Health)
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15 pages, 972 KiB  
Systematic Review
Environmental Planning and Non-Communicable Diseases: A Systematic Review on the Role of the Metabolomic Profile
by Natália Cristina de Oliveira, Pedro Balikian Júnior, Arnaldo Tenório da Cunha Júnior, Edson de Souza Bento, Josealdo Tonholo, Thiago Aquino, Filipe Antonio de Barros Sousa, Gustavo Gomes de Araujo and Maurício Lamano Ferreira
Int. J. Environ. Res. Public Health 2023, 20(14), 6433; https://doi.org/10.3390/ijerph20146433 - 23 Jul 2023
Viewed by 1811
Abstract
Non-communicable diseases (NCDs) are the major cause of death worldwide and have economic, psychological, and social impacts. Air pollution is the second, contributing to NCDs-related deaths. Metabolomics are a useful diagnostic and prognostic tool for NCDs, as they allow the identification of biomarkers [...] Read more.
Non-communicable diseases (NCDs) are the major cause of death worldwide and have economic, psychological, and social impacts. Air pollution is the second, contributing to NCDs-related deaths. Metabolomics are a useful diagnostic and prognostic tool for NCDs, as they allow the identification of biomarkers linked to emerging pathologic processes. The aim of the present study was to review the scientific literature on the application of metabolomics profiling in NCDs and to discuss environmental planning actions to assist healthcare systems and public managers based on early metabolic diagnosis. The search was conducted following PRISMA guidelines using Web of Science, Scopus, and PubMed databases with the following MeSH terms: “metabolomics” AND “noncommunicable diseases” AND “air pollution”. Twenty-nine studies were eligible. Eleven involved NCDs prevention, eight addressed diabetes mellitus, insulin resistance, systemic arterial hypertension, or metabolic syndrome. Six studies focused on obesity, two evaluated nonalcoholic fatty liver disease, two studied cancer, and none addressed chronic respiratory diseases. The studies provided insights into the biological pathways associated with NCDs. Understanding the cost of delivering care where there will be a critical increase in NCDs prevalence is crucial to achieving universal health coverage and improving population health by allocating environmental planning and treatment resources. Full article
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10 pages, 350 KiB  
Article
Engagement with Nature and the Home Environment: Wellbeing and Proenvironmental Behavior among Irish and Italian University Students during the COVID-19 Emergency
by Iana Ivanova Tzankova, Catherine O’Sullivan, Alessandra Iva Facciuto, Luciana Sacchetti, Fabiana Fini, Elvira Cicognani and Annalisa Setti
Int. J. Environ. Res. Public Health 2023, 20(14), 6432; https://doi.org/10.3390/ijerph20146432 - 23 Jul 2023
Cited by 2 | Viewed by 1295
Abstract
Growing evidence shows that exposure to nature and psychological engagement with nature improve health and wellbeing and promote greater proenvironmental engagement. The unprecedented situation created by COVID-related lockdowns seems to have brought both potential distress with household confinements and greater research on experiences [...] Read more.
Growing evidence shows that exposure to nature and psychological engagement with nature improve health and wellbeing and promote greater proenvironmental engagement. The unprecedented situation created by COVID-related lockdowns seems to have brought both potential distress with household confinements and greater research on experiences in nature. University students may have been particularly impacted as the quality of their home arrangements can vary substantially. The aim of the study was to examine how psychological engagement with nature (nature connectedness and noticing nature), time spent in nature, and household conditions relate to psychological wellbeing and proenvironmental behavior among university students. An online survey was administered to a sample of 566 university students from Italy and Ireland. Hierarchical multiple regressions were performed to investigate the relationships between variables. The results indicate that time spent in nature and psychological engagement with nature in terms of nature connectedness and noticing nature were associated with increased wellbeing and pro-nature-conservation behavior, controlling for demographic covariates. Moreover, the perception of chaos in one’s household was related to decreased wellbeing during the prolonged COVID-19 emergency. The findings highlight the need to invest in accessible natural places for students and to focus campus sustainability practices on encouraging nature connectedness to promote wellbeing and proenvironmental engagement. Full article
(This article belongs to the Special Issue Restorative Environments)
18 pages, 562 KiB  
Article
The Relationships between Compulsive Internet Use, Alexithymia, and Dissociation: Gender Differences among Italian Adolescents
by Alessandro Germani, Antonella Lopez, Elvira Martini, Sara Cicchella, Angelo Maria De Fortuna, Mirella Dragone, Barbara Pizzini, Gina Troisi and Raffaele De Luca Picione
Int. J. Environ. Res. Public Health 2023, 20(14), 6431; https://doi.org/10.3390/ijerph20146431 - 22 Jul 2023
Cited by 2 | Viewed by 1918
Abstract
Internet Gaming Disorder, Internet Addiction, Problematic Internet Use and Compulsive Internet Use cause distress and significant impairment in important areas of a person’s functioning, in particular among young people. The literature has indicated that males show higher levels of problematic internet use than [...] Read more.
Internet Gaming Disorder, Internet Addiction, Problematic Internet Use and Compulsive Internet Use cause distress and significant impairment in important areas of a person’s functioning, in particular among young people. The literature has indicated that males show higher levels of problematic internet use than females. People can use the internet to avoid or alleviate negative affects; in fact, problematic internet use is associated with alexithymia and dissociation. Few studies have focused on the different stages of adolescence, gender differences, and the relationships between the aforementioned variables. This research aims to fill this gap. Five hundred and ninety-four adolescents aged between 13 and 19 filled in the Compulsive Internet Use Scale, the Toronto Alexithymia Scale, the Adolescents Dissociative Experiences Scale, and other ad hoc measures. Surprisingly, females reported higher compulsive internet use compared with males. Moreover, they referred more difficulties/symptoms and greater levels of alexithymia than males. No differences across the stages of adolescence were found. Different strengths in the relationships between variables were found according to gender. Moderated mediation analyses indicated that dissociation is an important mediator in the relation between alexithymia and Compulsive Internet Use only among females. This study shed new light on gender differences around problematic internet use and some related risk factors, in order to identify and develop prevention and treatment programs to face this topical and relevant issue. Full article
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13 pages, 343 KiB  
Article
Barriers to Learning Healthcare-Associated Infections Prevention and Control during Clinical Practicum among Nursing Students in Korea: A Focus Group Study
by Eunyoung Park, Hyung-Ran Park and Ji-Hye Lee
Int. J. Environ. Res. Public Health 2023, 20(14), 6430; https://doi.org/10.3390/ijerph20146430 - 22 Jul 2023
Cited by 2 | Viewed by 1477
Abstract
Healthcare-associated infections (HAI) refer to infections that patients may acquire from healthcare facilities through nursing activities. Nursing students involved in patient care are regularly exposed to an array of pathogens and clinical practicum is essential for them to appropriately practice HAI prevention and [...] Read more.
Healthcare-associated infections (HAI) refer to infections that patients may acquire from healthcare facilities through nursing activities. Nursing students involved in patient care are regularly exposed to an array of pathogens and clinical practicum is essential for them to appropriately practice HAI prevention and control. This study aimed to explore the barriers to learning HAI prevention and control experienced by nursing students during their clinical practicum. A qualitative study was performed using focus group interviews. A total of 12 nursing students from South Korea, consisting of six third-year students and six fourth-year students, were enrolled. Both groups had taken clinical practicum courses. Data were collected using semi-structured questions and analyzed with conventional content analysis. Barriers experienced by the participants when learning HAI prevention and control were limited learning opportunities, inadequate infection control-related knowledge, inadequate practicum experience, and passive learning attitudes. Addressing the identified barriers would allow nursing students to effectively acquire infection control competencies during their clinical practicum. Full article
13 pages, 381 KiB  
Article
Psychometric Properties of the Polish Version of the Sports Anxiety Scale-2 (SAS-2)
by Kanupriya Rawat, Aleksandra Błachnio and Krzysztof Suppan
Int. J. Environ. Res. Public Health 2023, 20(14), 6429; https://doi.org/10.3390/ijerph20146429 - 22 Jul 2023
Viewed by 1325
Abstract
The main aim of the study was to assess the psychometric properties of the Polish version of the Sports Anxiety scale-2 (SAS-2). The study covered 396 athletes, ages ranging from 18 years to 35 years. The task and ego orientation in sport questionnaire [...] Read more.
The main aim of the study was to assess the psychometric properties of the Polish version of the Sports Anxiety scale-2 (SAS-2). The study covered 396 athletes, ages ranging from 18 years to 35 years. The task and ego orientation in sport questionnaire (TEOSQ) and State and Trait Anxiety Inventory (STAI) were used for validation of the scale. Cronbach’s alpha for the somatic anxiety subscale was 0.88, for the worry subscale was 0.95, and for the concentration disruption was 0.86, respectively. The three-factor model and hierarchical model fits perfectly as CFI > 0.95, TLI > 0.95, and RMSEA < 0.08. Satisfactory results in measurement invariance show the use of the tool for any gender or athlete (high-performance, recreational) group. The internal consistency (α = 0.86–0.95) and the test–retest reliability (ICC = 0.87–0.90) were satisfactory. There was a statistically significant negative correlation between task orientation and total anxiety along with its three subscales, and a weak positive correlation between ego orientation and worry subscale. Meanwhile, a weak to moderate positive correlation was exhibited between total anxiety and its subscales with the STAI-T and STAI-S. Additionally, female, recreational, and female recreational athletes’ groups had weak negative associations between worry and concentration disruption trait anxiety and task orientation, and a weak positive association between somatic anxiety and ego orientation. Full article
(This article belongs to the Special Issue Effects of Sports Training and Physical Conditioning on Human Health)
13 pages, 398 KiB  
Article
Association of Emotional Self-Regulation with Psychological Distress and Positive Functioning Dimensions in Brazilian University Students during the COVID-19 Pandemic
by Maurício Rech, Gabriela Bertoletti Diaz, Bruno Luis Schaab, Carolina Garcia Soares Leães Rech, Prisla Ücker Calvetti and Caroline Tozzi Reppold
Int. J. Environ. Res. Public Health 2023, 20(14), 6428; https://doi.org/10.3390/ijerph20146428 - 22 Jul 2023
Viewed by 2030
Abstract
Emotional self-regulation is a relevant factor for human development capable of minimizing emotional difficulties in the face of adverse events, as was particularly useful during the COVID-19 pandemic. The present study aimed to evaluate emotional self-regulation in Brazilian health science university students and [...] Read more.
Emotional self-regulation is a relevant factor for human development capable of minimizing emotional difficulties in the face of adverse events, as was particularly useful during the COVID-19 pandemic. The present study aimed to evaluate emotional self-regulation in Brazilian health science university students and its relationship with positive psychology constructs (subjective well-being, hope, optimism, spirituality, self-compassion, and self-efficacy) and psychological distress (depression, anxiety, and stress). This was a prospective, cross-sectional, observational, analytic study of 1062 Brazilian undergraduate students with data collected using self-administered online questionnaires. Students in the first years of their undergraduate degree programs had significantly higher dysregulation scores than those in the final years. Multiple linear regression yielded a model that explained 71.8% of the variation in emotion dysregulation. The correlations of emotion dysregulation were significant and strong, scoring negatively with self-compassion, optimism, and subjective well-being and positively with psychological distress. Full article
(This article belongs to the Special Issue The Impacts of COVID-19 on Mental Health and Well-Being)
20 pages, 391 KiB  
Article
A Market of Lived Experience—User Involvement and the Commodification of Personal Experiences of Mental Illness
by Erik Eriksson
Int. J. Environ. Res. Public Health 2023, 20(14), 6427; https://doi.org/10.3390/ijerph20146427 - 22 Jul 2023
Cited by 1 | Viewed by 1967
Abstract
Working actively to engage service users in participatory practices is both a policy expectation and a moral imperative for mental health social workers in contemporary Western mental health care. Recent research suggests that such practices of service user involvement are becoming increasingly individualised [...] Read more.
Working actively to engage service users in participatory practices is both a policy expectation and a moral imperative for mental health social workers in contemporary Western mental health care. Recent research suggests that such practices of service user involvement are becoming increasingly individualised and driven by market logic. Based on an ethnographic study within a Swedish public psychiatric organisation, this article applies the concept of commodification to examine this trend. By showing how the practice of user involvement takes the form of a market where personal narratives and experiences of mental health problems are bought and sold as commodities, the analysis illuminates how market logic permeates the everyday practice of user involvement. One consequence of this commodification is that user organisations, as well as individual service users, are restricted in their role as independent actors pursuing their own agenda, and instead increasingly act on behalf of the public and as providers of personal experiences. While it is vital that service user perspectives are heard and recognised within mental health services, mental health social workers need to be aware of the risks of commodifying lived experience. When attention is directed to individual experiences and narratives, there is a risk that opportunities to advocate on behalf of the user collective as a whole and speak from a more principled and socio-political standpoint are lost. In addition, the commodification of personal experience tends to rationalise and privilege user narratives that conform to the dominant institutional logic of the mental health organisation, while excluding more uncomfortable and challenging voices, thereby undermining the ability of service users to raise critical issues that do not align with the interests of the mental health organisation. Full article
24 pages, 615 KiB  
Article
A New eHealth Investment Appraisal Framework for Africa: Validation
by Sean C. Broomhead, Maurice Mars and Richard E. Scott
Int. J. Environ. Res. Public Health 2023, 20(14), 6426; https://doi.org/10.3390/ijerph20146426 - 21 Jul 2023
Viewed by 871
Abstract
(1) Background: Decisions to use eHealth are complex and involve addressing a large opportunity cost. Sound choices are essential. Weighing up investment options is challenging in resource-constrained settings where there are frequently insufficient economics data and expertise to conduct adequate appraisals. To address [...] Read more.
(1) Background: Decisions to use eHealth are complex and involve addressing a large opportunity cost. Sound choices are essential. Weighing up investment options is challenging in resource-constrained settings where there are frequently insufficient economics data and expertise to conduct adequate appraisals. To address this, a new eHealth Investment Appraisal Framework (eHIAF) for Africa has been designed and developed. The aim of this paper was to validate the new framework to consider whether it is fit for purpose and to refine it as needed. (2) Methods: An online survey of purposively selected eHealth experts was used to conduct a desktop validation of the proposed eHIAF for Africa. The survey covered the framework development process, structure, content, completeness, and utility. Expert opinions were charted, and a reflective and iterative process used to assess the tool and extract recommendations for refinement. (3) Results: Eleven eHealth experts who completed the survey had experience in African countries and elsewhere. The majority agreed with the eHIAF for Africa development approach and output. They provided valuable suggestions for minor refinements and felt that with these amendments, the eHIAF for Africa would be ‘fit for purpose’. (4) Conclusions: The eHIAF for Africa is considered appropriate for use by policy- and decision-makers working in resource-constrained settings who face the task of selecting optimal eHealth investments. It has the potential for applicability beyond Africa and the framework should now be tested in African countries. Full article
(This article belongs to the Section Digital Health)
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17 pages, 1066 KiB  
Article
Examining the Psychoactive Differences between Kratom Strains
by Guido Huisman, Maximilian Menke, Oliver Grundmann, Rudy Schreiber and Natasha Mason
Int. J. Environ. Res. Public Health 2023, 20(14), 6425; https://doi.org/10.3390/ijerph20146425 - 21 Jul 2023
Viewed by 5455
Abstract
Kratom (Mitragyna speciosa) is a Southeast Asian plant containing various alkaloids that induce pharmacological effects in humans. In Western countries, online vendors sell a variety of different kratom strains which are marketed to have distinct effect profiles. However, as of yet [...] Read more.
Kratom (Mitragyna speciosa) is a Southeast Asian plant containing various alkaloids that induce pharmacological effects in humans. In Western countries, online vendors sell a variety of different kratom strains which are marketed to have distinct effect profiles. However, as of yet such marketing claims are unsubstantiated, and therefore the current study investigated whether differently colored kratom products can induce distinct effects, as self-reported by users. Six hundred forty-four current kratom users were anonymously surveyed to compare the self-reported effects of and motivations for using kratom products sold as red, green, and white strains. Most of the survey respondents were customers of the same kratom vendor, the products of which had been analyzed for their alkaloid content by an independent laboratory. The survey respondents reported distinct subjective experiences for different kratom strains, in a manner congruent with common marketing descriptions. However, the product analyses revealed no significant cross-strain differences in alkaloid content, suggesting that the reported effect differences might be disproportionally influenced by marketing narratives and anecdotal reports. Future studies should engage a more diverse population and include kratom strains from various vendors. Controlled, blinded experiments could assess whether the reported effect differences stem from a placebo effect or from alternative factors, e.g., minor alkaloids and terpenes. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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15 pages, 363 KiB  
Article
Knowledge, Attitudes, and Practices Regarding Menstrual Hygiene among Girls in Ghizer, Gilgit, Pakistan
by Sanober Fazal Shah, Neelam Saleem Punjani, Syeda Naghma Rizvi, Sana Sadiq Sheikh and Rafat Jan
Int. J. Environ. Res. Public Health 2023, 20(14), 6424; https://doi.org/10.3390/ijerph20146424 - 21 Jul 2023
Cited by 1 | Viewed by 5344
Abstract
Introduction: Menstrual hygiene is a critical issue encountered by women and girls of reproductive age that negatively affects their health and empowerment. It is still deemed a taboo subject in several parts of the world, and girls hesitate to discuss menstruation with their [...] Read more.
Introduction: Menstrual hygiene is a critical issue encountered by women and girls of reproductive age that negatively affects their health and empowerment. It is still deemed a taboo subject in several parts of the world, and girls hesitate to discuss menstruation with their family members, friends, or schoolteachers, which creates hurdles when they experience their menarche. Girls residing in rural areas encounter more problems, since they lack proper resources and knowledge to manage their menstruation in school as well as at home. The purpose of this study was to evaluate the knowledge, attitudes, and practices regarding the menstrual hygiene of girls residing in rural areas of Gilgit, Pakistan. Methods: A descriptive cross-sectional design was used to assess the study questions. The consecutive sampling technique was applied to recruit 300 female participants from remote areas of Gilgit, Pakistan, who were 13 to 22 years old. A pre-tested questionnaire was utilized to collect the data, and SPSS version 21.0 was used to analyze them. Results: The study found that more than half of the participants had a poor level of knowledge and practices and negative attitudes towards menstrual hygiene. This could be due to many cultural and social factors associated with menstrual hygiene. Conclusions: The study concluded that the study participants were not knowledgeable about menstrual hygiene. They had poor practices and attitudes regarding menstrual hygiene. Hence, it is recommended that frequent sessions should be conducted by healthcare workers to enhance the knowledge of parents, teachers, and young girls, to increase their positive attitudes and practices regarding menstrual hygiene. Full article
(This article belongs to the Special Issue Adolescent and Youth Sexual and Reproductive Health and Rights)
18 pages, 701 KiB  
Article
Time-to-Treatment Initiation in a Decentralised Community-Care Model of Drug-Resistant Tuberculosis Management in the OR Tambo District Municipality of South Africa
by Joshua Oise Iruedo and Michael K. Pather
Int. J. Environ. Res. Public Health 2023, 20(14), 6423; https://doi.org/10.3390/ijerph20146423 - 21 Jul 2023
Cited by 1 | Viewed by 1174
Abstract
Background: Drug-resistant tuberculosis (DR-TB) continues to challenge global efforts toward eradicating and having a tuberculosis-free world. Considering the high early mortality, especially among HIV-infected individuals, early diagnosis and prompt initiation of effective treatment are needed to significantly reduce mortality and halt transmission of [...] Read more.
Background: Drug-resistant tuberculosis (DR-TB) continues to challenge global efforts toward eradicating and having a tuberculosis-free world. Considering the high early mortality, especially among HIV-infected individuals, early diagnosis and prompt initiation of effective treatment are needed to significantly reduce mortality and halt transmission of DR-TB in the community. Aim: This study aims to assess the effectiveness of a community DR-TB care model with the specific objective of determining the Time-to-treatment initiation of DR-TB among patients in the OR Tambo district municipality. Methods: A prospective cohort study of patients with DR-TB was conducted in the OR Tambo district municipality of Eastern Cape Province, South Africa. Patients were enrolled as they presented for treatment initiation at the decentralised facilities following a diagnosis of DR-TB and compared with a centralised site. Results: A total of 454 DR-TB patients from six facilities between 2018 and 2020 were included in the analysis. The mean age was 37.54 (SD = 14.94) years. There were slightly more males (56.2%) than females (43.8%). Most of the patients were aged 18–44 years (67.5%), without income (82.3%). Results showed that slightly over thirteen percent (13.4%) of patients initiated treatment the same day they were diagnosed with DR-TB, while 36.3% were on the time-to-treatment target of being initiated within 5 days. However, about a quarter (25.8%) of patients failed to initiate treatment two weeks after diagnosis. Time-to-treatment initiation (TTTI) varied according to the decentralised sites, with progressive improvement with each successive year between 2018 and 2021. No demographic factor was significantly associated with TTTI. Conclusion: Despite rapid diagnosis, only 36% of patients were initiated on treatment promptly. Operational challenges remained, and services needed to be reorganised to maximise the exceptional potentials that a decentralised community DR-TB care model brings. Full article
(This article belongs to the Special Issue Chronic Disease Prevention and Management in Primary Health Care)
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20 pages, 949 KiB  
Systematic Review
The Effectiveness of Nursing Rehabilitation Interventions on Self-Care for Older Adults with Respiratory Disorders: A Systematic Review with Meta-Analysis
by Rita Ribeiro, Henrique Oliveira, Margarida Goes, Cátia Gonçalves, Ana Dias and César Fonseca
Int. J. Environ. Res. Public Health 2023, 20(14), 6422; https://doi.org/10.3390/ijerph20146422 - 20 Jul 2023
Cited by 2 | Viewed by 3470
Abstract
Background: This research work aimed to summarize the rehabilitation nursing interventions published in the scientific literature that most contribute to effective adherence to self-care in older adults with respiratory diseases. Methods: A systematic literature review with meta-analysis was conducted by searching [...] Read more.
Background: This research work aimed to summarize the rehabilitation nursing interventions published in the scientific literature that most contribute to effective adherence to self-care in older adults with respiratory diseases. Methods: A systematic literature review with meta-analysis was conducted by searching the EBSCOhost platform (CINAHL Complete, MEDLINE Complete, Cochrane, and MedicLatina) using the PRISMA methodology. Five articles were selected for final analysis. Meta-analysis was carried out using Comprehensive Meta-Analysis (CMA) software, and the results were presented in a forest plot. Results: Thirty-one self-promoting rehabilitation nursing interventions were identified, with the most effective being those related to the assessment of progress in physical capacity/activity tolerance (functional status category/domain) and the assessment of the increase in health-related quality of life (health-related quality of life category/domain). Conclusions: Rehabilitation nursing interventions such as self-management programs led by nurses, community-based and home-based rehabilitation programs, and inspiratory muscle training can effectively reduce and enable the effective control of symptoms associated with respiratory disorders, boosting older adults’ empowerment to engage in self-care. Full article
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14 pages, 339 KiB  
Article
Immigrants’ Experiences and Perceptions of COVID-19 Information in Norway
by Seila Mahic, Line Nortvedt and Lise-Merete Alpers
Int. J. Environ. Res. Public Health 2023, 20(14), 6421; https://doi.org/10.3390/ijerph20146421 - 20 Jul 2023
Viewed by 1098
Abstract
When the COVID-19 virus hit the world, immigrants were overrepresented among those infected. In Norway, throughout the pandemic, there were far higher infection rates in people of Somali and Pakistani descent than in the rest of the population. The first aim of this [...] Read more.
When the COVID-19 virus hit the world, immigrants were overrepresented among those infected. In Norway, throughout the pandemic, there were far higher infection rates in people of Somali and Pakistani descent than in the rest of the population. The first aim of this study is to explore the experiences and perceptions of immigrants from Somalia and Pakistan living in Oslo regarding the different sources of COVID-19 information that they referred to at the beginning of the pandemic. The second aim is to suggest and discuss measures to improve practice in the event of a new pandemic. Four semi-structured focus-group interviews were conducted with a total of 27 first-generation immigrants from Somalia and Pakistan. The results showed that the immigrants found various COVID-19 information sources to be important. These sources are further presented in three categories: (1) COVID-19 information from the authorities through mass communication; (2) family, friends, and local environments as sources of information; (3) information from religious communities and volunteer resource personnel. We conclude that the participants were active users of available information from different sources and channels. Stigmatization made a negative contribution and religion made a positive contribution to coping and to trust in the authorities. Full article
14 pages, 3186 KiB  
Article
The Analysis of 222Rn and 220Rn Natural Radioactivity for Local Hazard Estimation: The Case Study of Cerveteri (Central Italy)
by Nunzia Voltattorni, Andrea Gasparini and Gianfranco Galli
Int. J. Environ. Res. Public Health 2023, 20(14), 6420; https://doi.org/10.3390/ijerph20146420 - 20 Jul 2023
Cited by 2 | Viewed by 1096
Abstract
Radon (222Rn) is the second most common cause of lung cancer after smoking. As radon poses a significant risk to human health, radon-affected areas should be identified to ensure people’s awareness of risk and remediation. The primary goal of this research [...] Read more.
Radon (222Rn) is the second most common cause of lung cancer after smoking. As radon poses a significant risk to human health, radon-affected areas should be identified to ensure people’s awareness of risk and remediation. The primary goal of this research was to investigate the local natural radioactivity (in soils, groundwater, and indoors) because of the presence of tuff outcrops (from middle–lower Pleistocene volcanic activity) that naturally produce radioactive gas radon at Cerveteri (Rome, Central Italy). The results of the radon survey highlighted moderate (>16,000 Bq/m3) but localized anomalies in soils in correspondence with a funerary site pertaining to the Etruscan Necropolis of Cerveteri, which extends over a volcanic rock plateau. Indoor radon measurements were performed at several tuff-made dwellings, and the results showed medium-low (<200 Bq/m3) values of indoor radon except for some cases exceeding the reference level (>300 Bq/m3) recommended by the 2013/59 Euratom Directive. Although no clinical data exist regarding the health effects of thoron (220Rn) on humans, the study of 220Rn average activity concentration in the soil gas survey reveals new insights for the interpretation of radon sources that can affect dwellings, even taking into account the considerable difference in the half-lives of 222Rn and 220Rn. Full article
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29 pages, 5076 KiB  
Systematic Review
Effect of Assisted Surgery on Work-Related Musculoskeletal Disorder Prevalence by Body Area among Surgeons: Systematic Review and Meta-Analysis
by Philippe Gorce and Julien Jacquier-Bret
Int. J. Environ. Res. Public Health 2023, 20(14), 6419; https://doi.org/10.3390/ijerph20146419 - 20 Jul 2023
Cited by 2 | Viewed by 1518
Abstract
Surgeons are highly exposed to work-related musculoskeletal disorders (WMSDs). The objective of this review was to summarize the WMSD prevalence by body area with and without assistive devices. The underlying question was whether there is an effect of assistive device use (robot, video, [...] Read more.
Surgeons are highly exposed to work-related musculoskeletal disorders (WMSDs). The objective of this review was to summarize the WMSD prevalence by body area with and without assistive devices. The underlying question was whether there is an effect of assistive device use (robot, video, or other) during surgery on WMSD prevalence by body area among surgeons, regardless of their specialty. The systematic review was conducted according to the PRISMA guidelines. The Google Scholar, Pubmed/Medline, and ScienceDirect databases were scanned to identify relevant studies. The article selection, review, critical appraisal, and data extraction were performed by two authors independently. Among the 34,854 unique identified records, 77 studies were included. They were divided into two groups: 35 focused on robotic- and video-assisted surgery (RVAS) and 48 concerning surgery without video/robotic assistance (WAS) (6 studies evaluated the prevalence for both groups). WMSD prevalence was reported for 13 body areas: the neck, back, upper back, mid-back, lower back, shoulders, elbows, wrists, fingers, thumbs, hips, knees, and ankles. The results showed that WMSD prevalence was significantly higher (unpaired t-test, p < 0.05) for RVAS in the shoulders (WAS: 28.3% vs. RVAS: 41.9%), wrists (WAS: 20.9% vs. RVAS: 31.5%), and thumbs (WAS: 9.9% vs. RVAS: 21.8%). A meta-analysis was performed for 10 body areas (with 4 areas including more than 25 studies). No sufficient data were available for the mid-back, thumbs, or hips. A high heterogeneity (Cochran’s Q test and I2 statistic) was observed. A random-effects model revealed that the highest worldwide prevalence was in the neck (WAS: 41% and RVAS: 45.3%), back (WAS: 37.7% and RVAS: 49.9%), lower back (WAS: 40.0% and RVAS: 37.8%), and shoulders (WAS: 27.3% and RVAS: 41.4%). Future work could focus on work environment design, particularly the positioning and adjustment of equipment, and on postural analysis to reduce the appearance of WMSDs. Recommendations are proposed for future reviews and meta-analyses. Full article
(This article belongs to the Section Public Health Statistics and Risk Assessment)
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17 pages, 364 KiB  
Article
Health Service Implementation and Antifragile Characteristics in Rural Communities: A Dirt Research Approach
by Samuel Petrie and Paul Peters
Int. J. Environ. Res. Public Health 2023, 20(14), 6418; https://doi.org/10.3390/ijerph20146418 - 20 Jul 2023
Viewed by 1153
Abstract
The implementation of health and care services within rural communities requires necessary sensitivity to the unique facets of rural places. Often, rural service implementation is executed with inappropriate frameworks based on assumptions derived from urban centres. To understand the characteristics of rural communities [...] Read more.
The implementation of health and care services within rural communities requires necessary sensitivity to the unique facets of rural places. Often, rural service implementation is executed with inappropriate frameworks based on assumptions derived from urban centres. To understand the characteristics of rural communities that can facilitate successful program implementation better, ethnographic accounts of rural health and care services were compiled in rural communities within Canada, Australia, and Iceland. Ethnographic accounts are presented in the first and third person, with an accompanying reflexive analysis immediately following these accounts. Antifragility was the guiding concept of interest when investigating rural implementation environments, a concept that posits that a system can gain stability from uncertainty rather than lose integrity. These ethnographic accounts provide evidence of antifragile operators such as optionality, hybrid leadership, starting small, nonlinear evaluation, and avoiding suboptimisation. It is shown that the integration of these antifragile operators allows programs to function better in complex rural systems. Further, the presence of capable individuals with sufficient knowledge in several disciplines and with depth in a single discipline allows for innovative local thinking initiatives. Full article
(This article belongs to the Special Issue Public Health: Rural Health Services Research)
9 pages, 347 KiB  
Article
Strategies of Modelling Incident Outcomes Using Cox Regression to Estimate the Population Attributable Risk
by Marlien Pieters, Iolanthe M. Kruger, Herculina S. Kruger, Yolandi Breet, Sarah J. Moss, Andries van Oort, Petra Bester and Cristian Ricci
Int. J. Environ. Res. Public Health 2023, 20(14), 6417; https://doi.org/10.3390/ijerph20146417 - 20 Jul 2023
Viewed by 1236
Abstract
When the Cox model is applied, some recommendations about the choice of the time metric and the model’s structure are often disregarded along with the proportionality of risk assumption. Moreover, most of the published studies fail to frame the real impact of a [...] Read more.
When the Cox model is applied, some recommendations about the choice of the time metric and the model’s structure are often disregarded along with the proportionality of risk assumption. Moreover, most of the published studies fail to frame the real impact of a risk factor in the target population. Our aim was to show how modelling strategies affected Cox model assumptions. Furthermore, we showed how the Cox modelling strategies affected the population attributable risk (PAR). Our work is based on data collected in the North-West Province, one of the two PURE study centres in South Africa. The Cox model was used to estimate the hazard ratio (HR) of mortality for all causes in relation to smoking, alcohol use, physical inactivity, and hypertension. Firstly, we used a Cox model with time to event as the underlying time variable. Secondly, we used a Cox model with age to event as the underlying time variable. Finally, the second model was implemented with age classes and sex as strata variables. Mutually adjusted models were also investigated. A statistical test to the multiplicative interaction term the exposures and the log transformed time to event metric was used to assess the proportionality of risk assumption. The model’s fitting was investigated by means of the Akaike Information Criteria (AIC). Models with age as the underlying time variable with age and sex as strata variables had enhanced validity of the risk proportionality assumption and better fitting. The PAR for a specific modifiable risk factor can be defined more accurately in mutually adjusted models allowing better public health decisions. This is not necessarily true when correlated modifiable risk factors are considered. Full article
16 pages, 1642 KiB  
Article
One Health and Australian Aboriginal and Torres Strait Islander Communities: A One Health Pilot Study
by Tamara Riley, Bonny Cumming, Joanne Thandrayen, Anna Meredith, Neil E. Anderson and Raymond Lovett
Int. J. Environ. Res. Public Health 2023, 20(14), 6416; https://doi.org/10.3390/ijerph20146416 - 20 Jul 2023
Cited by 2 | Viewed by 1565
Abstract
Many Aboriginal and Torres Strait Islander communities face barriers in accessing animal healthcare and are exposed to disproportionate environmental health exposures leading to increased risk of disease. A One Health approach has been promoted to address public health risks and improve human, animal, [...] Read more.
Many Aboriginal and Torres Strait Islander communities face barriers in accessing animal healthcare and are exposed to disproportionate environmental health exposures leading to increased risk of disease. A One Health approach has been promoted to address public health risks and improve human, animal, and environmental health outcomes in communities. We undertook a pilot One Health study in Aboriginal and Torres Strait Islander communities in Queensland collecting animal, human, and environmental health data from 82 households. We performed a descriptive analysis and assessed the association between human and environmental health exposures and animal health outcomes. Most households were not crowded (82.9%) but did report a high level of environmental health concerns (86.6%). The majority of households owned cats and dogs (81.7%), with most animals assessed as healthy. There was no association between human and environmental health exposures and animal health outcomes. As most households experienced concerns regarding housing conditions, environmental health programs should prioritise improving household factors. There was also strong support for animal healthcare (including access to medicines and veterinarians, education programs and population management), indicating that a One Health approach is desired by communities. Full article
(This article belongs to the Special Issue One Health including and beyond Zoonoses)
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12 pages, 1076 KiB  
Article
Association of D-Dimer, C-Reactive Protein, and Ferritin with COVID-19 Severity in Pregnant Women: Important Findings of a Cross-Sectional Study in Northern Brazil
by Jenephy Thalita Rosa Paixão, Carolinne de Jesus Santos e Santos, Ana Paula Figueiredo de Montalvão França, Sandra Souza Lima, Rogério Valois Laurentino, Ricardo Roberto de Souza Fonseca, Antonio Carlos Rosário Vallinoto, Aldemir Branco Oliveira-Filho and Luiz Fernando Almeida Machado
Int. J. Environ. Res. Public Health 2023, 20(14), 6415; https://doi.org/10.3390/ijerph20146415 - 20 Jul 2023
Cited by 1 | Viewed by 1291
Abstract
Background: The COVID-19 pandemic has had a great impact on pregnant women due to the broad clinical spectrum of the disease. The present study investigated the profile of three biomarkers during hospital admission of pregnant women—D-dimer, C-reactive protein (CRP), and ferritin—and their correlation [...] Read more.
Background: The COVID-19 pandemic has had a great impact on pregnant women due to the broad clinical spectrum of the disease. The present study investigated the profile of three biomarkers during hospital admission of pregnant women—D-dimer, C-reactive protein (CRP), and ferritin—and their correlation with the severity and outcome of COVID-19. Methods: The cross-sectional study included 226 pregnant women hospitalized in the city of Belém, Pará, Northern Brazil, from April 2020 to July 2021. Epidemiological and laboratory data were obtained from medical records, and all pregnant women underwent RT-PCR molecular testing for the detection of SARS-CoV-2. Results: In total, 121 (53.5%) were positive and 105 (46.5%) were negative for SARS-CoV-2 using RT-PCR. Most pregnant women (49.5%) with COVID-19 were between 26 and 34 years old, were residing in the interior of the state of Pará (51.2%), and were in the third gestational trimester (71.9%). In addition, 71.1% of them were admitted to the ward and 28.9% were admitted to the intensive care unit (ICU), with 90.9% surviving COVID-19. The concentrations of D-dimer (p = 0.0122) and ferritin (p ≤ 0.0001) were significantly higher among pregnant women with COVID-19, especially among those hospitalized in the ICU. Conclusion: Ferritin and D-dimer seem to serve as important biomarkers for the prognosis of COVID-19 in pregnant women, which was not observed for CRP. Full article
(This article belongs to the Special Issue Research on Maternal and Reproductive Health)
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15 pages, 2182 KiB  
Article
Patients’ Perspectives on the Use of a Newly Developed “Patients’ Guide for Doctor’s Visit”: DocVISITguide
by Rebecca Jaks, Elena Guggiari, Saskia Maria De Gani and Dunja Nicca
Int. J. Environ. Res. Public Health 2023, 20(14), 6414; https://doi.org/10.3390/ijerph20146414 - 20 Jul 2023
Viewed by 1156
Abstract
During doctor’s visits, fundamental decisions regarding a patient’s diagnosis and therapy are taken. However, consultations often take place within a limited time frame and are characterized by an asymmetric interaction. Therefore, patients’ questions can remain unanswered and concerns unspoken. A "Patients’ Guide for [...] Read more.
During doctor’s visits, fundamental decisions regarding a patient’s diagnosis and therapy are taken. However, consultations often take place within a limited time frame and are characterized by an asymmetric interaction. Therefore, patients’ questions can remain unanswered and concerns unspoken. A "Patients’ Guide for Doctor’s Visit" (DocVISITguide) was developed to prepare patients for their visits, supporting them to take an active role in the communication and leave the consultation well-informed. This paper describes the development of the DocVISITguide and its first small-scale evaluation based on a sequential explanatory mixed methods design from the patients’ perspective. For this purpose, a small sample of patients completed a pre- and post-questionnaire, and two in-depth interviews were conducted. Most participants found the DocVISITguide easy to understand. The guide helped them to take a closer look at their own health situation and be better prepared for the visit. More than three-quarters (82%) of the participants would probably use the guide again, and all (100%) would recommend it to family and friends. However, some patients felt unsure about using the guide within the consultation and showing it to their physician. To counteract this uncertainty, physicians should be actively involved in the use of such guides in the future. Full article
(This article belongs to the Special Issue Primary Care and Global Community Health)
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11 pages, 1052 KiB  
Article
Examining the Role of Quality of Institutionalized Healthcare on Maternal Mortality in the Dominican Republic
by Maria De Jesus, Nora Sullivan, William Hopman, Alex Martinez, Paul David Glenn II, Saviour Msopa, Brooke Milligan, Noah Doney, William Howell, Kimberly Sellers and Monica C. Jackson
Int. J. Environ. Res. Public Health 2023, 20(14), 6413; https://doi.org/10.3390/ijerph20146413 - 20 Jul 2023
Viewed by 1417
Abstract
The main study objective was to determine the extent to which the quality of institutionalized healthcare, sociodemographic factors of obstetric patients, and institutional factors affect maternal mortality in the Dominican Republic. COM-Poisson distribution and the Pearson correlation coefficient were used to determine the [...] Read more.
The main study objective was to determine the extent to which the quality of institutionalized healthcare, sociodemographic factors of obstetric patients, and institutional factors affect maternal mortality in the Dominican Republic. COM-Poisson distribution and the Pearson correlation coefficient were used to determine the relationship of predictor factors (i.e., hospital bed rate, vaginal birth rate, teenage mother birth rate, single mother birth rate, unemployment rate, infant mortality rate, and sex of child rate) in influencing maternal mortality rate. The factors hospital bed rate, teenage mother birth rate, and unemployment rate were not correlated with maternal mortality. Maternal mortality increased as vaginal birth rates and infant death rates increased whereas it decreased as single mother birth rates increased. Further research to explore alternate response variables, such as maternal near-misses or severe maternal morbidity is warranted. Additionally, the link found between infant death and maternal mortality presents an opportunity for collaboration among medical specialists to develop multi-faceted solutions to combat adverse maternal and infant health outcomes in the DR. Full article
(This article belongs to the Section Reproductive Health)
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19 pages, 985 KiB  
Article
Evaluating Somatic Experiencing® to Heal Cancer Trauma: First Evidence with Breast Cancer Survivors
by Denise Vagnini, Massimo Maria Grassi and Emanuela Saita
Int. J. Environ. Res. Public Health 2023, 20(14), 6412; https://doi.org/10.3390/ijerph20146412 - 20 Jul 2023
Cited by 1 | Viewed by 2679
Abstract
Somatic Experiencing® is a bio-psychological method for the treatment and prevention of trauma and chronic stress, which has never been investigated with breast cancer (BC) survivors. Eight weeks of web-based synchronous group sessions were structured between April and June 2022. Potential participants [...] Read more.
Somatic Experiencing® is a bio-psychological method for the treatment and prevention of trauma and chronic stress, which has never been investigated with breast cancer (BC) survivors. Eight weeks of web-based synchronous group sessions were structured between April and June 2022. Potential participants were recruited using a convenience sampling approach and through the collaboration of a public hospital in northern Italy and a non-profit association of BC women. Thirty-five eligible participants were enrolled and divided into an intervention group (n = 21) and a control group (n = 14). Anxiety, depression, distress (HADS), coping strategies (Mini-MAC), trauma reworking skills (PACT), and body image (BIS) were assessed at T0 and after 8 weeks (T1). Qualitative items concerning the most significant moments and learnings were completed at T1 by the intervention group. An independent t-test confirmed no between-group psychological differences at T0. As hypothesized, paired-sample t-tests showed decreases in anxiety, depression, distress (p < 0.05), and anxious preoccupation coping strategy (p < 0.001), but also improvements in forward focus (p < 0.05) and body image (p < 0.001) in the intervention group. The controls worsened over time with increases in hopeless/helplessness (p < 0.001) and avoidance (p < 0.05) coping strategies. Textual analyses extracted five dominant themes that summarized the meaning of the experience for participants. The preliminary results suggest the effectiveness of the intervention. Full article
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2 pages, 264 KiB  
Reply
Reply to Yap, C.K.; Ong, M.C. Comment on “Peycheva et al. Trace Elements and Omega-3 Fatty Acids of Wild and Farmed Mussels (Mytilus galloprovincialis) Consumed in Bulgaria: Human Health Risks. Int. J. Environ. Res. Public Health 2021, 18, 10023”
by Katya Peycheva and Nicola Cicero
Int. J. Environ. Res. Public Health 2023, 20(14), 6411; https://doi.org/10.3390/ijerph20146411 - 20 Jul 2023
Viewed by 726
Abstract
The authors would like to thank Yap and Ong [...] Full article
19 pages, 370 KiB  
Article
The Impact of Public Health Restrictions on Young Caregivers and How They Navigated a Pandemic: Baseline Interviews from a Longitudinal Study Conducted in Ontario, Canada
by Kristine Newman, Heather Chalmers, Arthur Ze Yu Wang, Sarah Ciotti, Luxmhina Luxmykanthan and Nicole Mansell
Int. J. Environ. Res. Public Health 2023, 20(14), 6410; https://doi.org/10.3390/ijerph20146410 - 20 Jul 2023
Viewed by 1216
Abstract
This qualitative research study is a part of a larger research project exploring the experiences of young caregivers aged 5–26 years and their families navigating the COVID-19 pandemic between 2020 to 2023. Data were collected from 14 young caregivers who participated in baseline [...] Read more.
This qualitative research study is a part of a larger research project exploring the experiences of young caregivers aged 5–26 years and their families navigating the COVID-19 pandemic between 2020 to 2023. Data were collected from 14 young caregivers who participated in baseline interviews. The central research question guiding this study: What was, is, and will be the impact of changing public health restrictions on young caregivers and their families during the pandemic and pandemic recovery? Seven themes emerged through analysis: (1) Navigating Care During the Height of Public Health Restrictions, (2) Neighbourhood and Built Environment During the Pandemic, (3) Perceptions Towards COVID-19 and Public Health Restrictions/Efforts, (4) The Impact of Public Health Restrictions on Relationships, (5) Mental Health Challenges of Being a Young Caregiver During a Pandemic, (6) Navigating Formal Services and Supports, and (7) Recommendations from Young Caregivers. The findings from this empirical research suggest that young caregivers found it easier to navigate their caregiving responsibilities when public health restrictions and work-from-home mandates were initially implemented; however, this later changed due to challenges in finding respite from caregiving, maintaining social connections with friends, creating personal space at home, and finding adequate replacements for programs once offered in person. Full article
(This article belongs to the Special Issue Young Carers: Research, Policy and Practice)
7 pages, 294 KiB  
Communication
Values Clarification Exercises to Prepare Nursing Students for Artificial Intelligence Integration
by Jennie C. De Gagne
Int. J. Environ. Res. Public Health 2023, 20(14), 6409; https://doi.org/10.3390/ijerph20146409 - 20 Jul 2023
Cited by 3 | Viewed by 2256
Abstract
Artificial intelligence (AI) is rapidly revolutionizing health care and education globally, including nursing practice and education. The responsible utilization of AI in a nursing context requires thoughtful consideration of its alignment with nursing values such as compassionate and patient-centered care provision, and respect [...] Read more.
Artificial intelligence (AI) is rapidly revolutionizing health care and education globally, including nursing practice and education. The responsible utilization of AI in a nursing context requires thoughtful consideration of its alignment with nursing values such as compassionate and patient-centered care provision, and respect for diverse perspectives. Values clarification, a vital teaching strategy in nursing education, can reinforce the foundational values and beliefs that guide nursing practice, thereby facilitating nurses’ critical evaluation of the ethical implications of AI implementation. The early introduction of values clarification into nursing education (a) provides students with a framework to prioritize and reflect on the impact of nursing values on their practice, (b) enables educators to make informed decisions and enhance teaching strategies, (c) contributes to the continual improvement of nursing education programs, and (d) fosters an ethical and values-driven approach to the integration of AI into nursing education and practice. This article examines the integration of values clarification into nursing education, offers strategies for nurse educators to integrate AI into their teaching toolkit effectively and ethically, and addresses concerns regarding potential misuses of AI. Full article
(This article belongs to the Special Issue Innovative Strategies and Global Perspectives in Nursing Education)
13 pages, 738 KiB  
Article
Habitual Physical Activity and Dietary Profiles in Older Japanese Males with Normal-Weight Obesity
by Yusei Tataka, Ayano Hiratsu, Kyoko Fujihira, Chihiro Nagayama, Kayoko Kamemoto, Takashi Fushimi, Hideto Takase and Masashi Miyashita
Int. J. Environ. Res. Public Health 2023, 20(14), 6408; https://doi.org/10.3390/ijerph20146408 - 20 Jul 2023
Cited by 1 | Viewed by 1280
Abstract
Normal-weight obesity is defined as having high body fat but a normal body mass index (BMI). This study examined whether there are differences in habitual physical activity and diet between individuals with normal-weight obesity and obese or non-obesity. This study included 143 males [...] Read more.
Normal-weight obesity is defined as having high body fat but a normal body mass index (BMI). This study examined whether there are differences in habitual physical activity and diet between individuals with normal-weight obesity and obese or non-obesity. This study included 143 males aged 65–75 years, and they were classified into the following three groups according to BMI and visceral fat area (VFA): obese group (n = 27 (BMI: ≥25 kg/m2 and VFA: ≥100 cm2)), normal-weight obese group (n = 35 (BMI: <25 kg/m2 and VFA: ≥100 cm2)) and non-obese group (n = 81 (BMI: <25 kg/m2 and VFA < 100 cm2)). Lowered high-density lipoprotein cholesterol and elevated triglyceride and alanine transaminase were observed in the normal-weight obese group than in the non-obese group (all for p ≤ 0.04, effect size ≥ 0.50). No differences were found in physical activity and dietary habits between non-obese and normal-weight obese groups (all for p > 0.05). Although impaired lipid and liver function parameters were observed in older males with normal-weight obesity compared with older males with non-obesity, physical activity and dietary profiles in themselves were not shown these differences in the present study. Full article
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